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Sex Differences, Academic Outcomes, and the Impact of Cranial Radiation in Pediatric Medulloblastoma

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Abstract

Introduction

Treatment for brain tumors in children has been associated with difficulties in neurocognitive functioning. The present study examined the differences in academic outcomes for male and female medulloblastoma survivors who were treated with and without cranial radiation.

Methods

Data from 39 medulloblastoma survivors were collected retrospectively. Patients included in the study were clinically referred for a neuropsychological evaluation. One-way ANOVAs were used to examine differences in academic outcomes for male and female patients as well as patients who received and did not receive radiation as part of their treatment.

Results

Analyses indicated significant differences across male and female medulloblastoma survivors for sight word reading, phonological decoding, and mathematical calculation. Significant differences were not observed for patients who did and did not receive cranial radiation.

Discussion

Similar to findings examining differences in intellectual outcomes for brain tumor survivors, males performed lower than females approximately 4 years post-treatment. This suggests that males may be particularly vulnerable to neurocognitive difficulties following treatment for medulloblastoma and earlier monitoring and assessment may be warranted. Sex differences in brain development may be related to academic outcomes for pediatric brain tumor patients. Additional research is needed in the area.

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Data Availability

De-identified data are available upon request.

Code Availability

Not applicable.

References

  • Bledsoe, J. C., Breiger, D., Breiger, M., Shonka, S., Ermoian, R. P., Ojemann, J. G., ... & Geyer, J. R. (2019). Differential trajectories of neurocognitive functioning in females versus males following treatment for pediatric brain tumors. Neuro-oncology, 21(10), 1310-1318. https://doi.org/10.1093/neuonc/noz092.

  • Bonner, M. J., Hardy, K. K., Willard, V. W., & Gururangan, S. (2009). Additional evidence of a nonverbal learning disability in survivors of pediatric brain tumors. Children's Health Care, 38(1), 49–63. https://doi.org/10.1080/02739610802615849

    Article  Google Scholar 

  • Callu, D., Viguier, D., Laroussinie, F., Puget, S., Boddaert, N., Kieffer, V., et al. (2009). Cognitive and academic outcome after benign or malignant cerebellar tumor in children. Cognitive and Behavioral Neurology, 22(4), 270–278. https://doi.org/10.1097/WNN.0b013e3181bf2d4c

    Article  Google Scholar 

  • Furnée, C. A., Groot, W., & van Den Brink, H. M. (2008). The health effects of education: a meta-analysis. European Journal of Public Health, 18(4), 417–421. https://doi.org/10.1093/eurpub/ckn028

    Article  Google Scholar 

  • Garcia, E., & Weiss, E. (2018). Student absenteeism: Who misses school and how missing school matters for performance. Economic Policy Institute. Retrieved from https://eric.ed.gov/?id=ED593361

  • Gurney, J. G., Krull, K. R., Kadan-Lottick, N., Nicholson, H. S., Nathan, P. C., Zebrack, B., ... & Ness, K. K. (2009). Social outcomes in the childhood cancer survivor study cohort. Journal of Clinical Oncology, 27(14), 2390. https://doi.org/10.1200/JCO.2008.21.1458.

  • Herman, K. C., Lambert, S. F., Ialongo, N. S., & Ostrander, R. (2007). Academic pathways between attention problems and depressive symptoms among urban African American children. Journal of Abnormal Child Psychology, 35(2), 265–274. https://doi.org/10.1007/s10802-006-9083-2

    Article  Google Scholar 

  • Kahalley, L. S., Ris, M. D., Grosshans, D. R., Okcu, M. F., Paulino, A. C., Chintagumpala, M., ... & Mahajan, A. (2016). Comparing intelligence quotient change after treatment with proton versus photon radiation therapy for pediatric brain tumors. Journal of Clinical Oncology, 34(10), 1043. https://doi.org/10.1200/JCO.2015.62.1383.

  • Kahalley, L. S., Douglas Ris, M., Mahajan, A., Fatih Okcu, M., Chintagumpala, M., Paulino, A. C., ... & Grosshans, D. R. (2019). Prospective, longitudinal comparison of neurocognitive change in pediatric brain tumor patients treated with proton radiotherapy versus surgery only. Neuro-oncology, 21(6), 809-818. https://doi.org/10.1093/neuonc/noz041.

  • Lenroot, R. K., Gogtay, N., Greenstein, D. K., Wells, E. M., Wallace, G. L., Clasen, L. S., ... & Giedd, J. N. (2007). Sexual dimorphism of brain developmental trajectories during childhood and adolescence. Neuroimage, 36(4), 1065-1073. https://doi.org/10.1016/j.neuroimage.2007.03.053.

  • McIntosh, K., Sadler, C., & Brown, J. A. (2012). Kindergarten reading skill level and change as risk factors for chronic problem behavior. Journal of Positive Behavior Interventions, 14(1), 17–28. https://doi.org/10.1177/1098300711403153

    Article  Google Scholar 

  • Millard, N. E., & De Braganca, K. C. (2016). Medulloblastoma. Journal of Child Neurology, 31(12), 1341–1353. https://doi.org/10.1177/0883073815600866

    Article  Google Scholar 

  • Moore III, B. D. (2005). Neurocognitive outcomes in survivors of childhood cancer. Journal of Pediatric Psychology, 30(1), 51-63. https://doi.org/10.1093/jpepsy/jsio16.

  • Moore, K. J., Moertel, C. L., & Williams, L. A. (2022). Minority children experience a higher risk of death from many central nervous system tumor types even after accounting for treatment received: A National Cancer Database analysis. Cancer, 128(8), 1605–1615. https://doi.org/10.1002/cncr.34121

    Article  Google Scholar 

  • Mulhern, R. K., Palmer, S. L., Merchant, T. E., Wallace, D., Kocak, M., Brouwers, P., ... & Gajjar, A. (2005). Neurocognitive consequences of risk-adapted therapy for childhood medulloblastoma. Journal of Clinical Oncology, 23(24), 5511-5519. https://doi.org/10.1200/JCO.2005.00.703.

  • Olsson, I. T., Perrin, S., Lundgren, J., Hjorth, L., & Johanson, A. (2014). Long-term cognitive sequelae after pediatric brain tumor related to medical risk factors, age, and sex. Pediatric Neurology, 51(4), 515–521. https://doi.org/10.1016/j.pediatrneurol.2014.06.011

    Article  Google Scholar 

  • Ostrom, Q. T., Cioffi, G., Gittleman, H., Patil, N., Waite, K., Kruchko, C., & Barnholtz-Sloan, J. S. (2019). CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012–2016. Neuro-oncology, 21(Supplement_5), v1-v100. https://doi.org/10.1093/neuonc/noz150.

  • Palmer, S. L., Goloubeva, O., Reddick, W. E., Glass, J. O., Gajjar, A., Kun, L., ... & Mulhern, R. K. (2001). Patterns of intellectual development among survivors of pediatric medulloblastoma: a longitudinal analysis. Journal of Clinical Oncology, 19(8), 2302-2308. https://doi.org/10.1200/JCO.2001.19.8.2302.

  • Pang, J. W., Friedman, D. L., Whitton, J. A., Stovall, M., Mertens, A. C., Robison, L. L., & Weiss, N. S. (2008). Employment status among adult survivors in the Childhood Cancer Survivor Study. Pediatric Blood & Cancer, 50(1), 104–110. https://doi.org/10.1002/pbc.21226

    Article  Google Scholar 

  • Riddell, W. C., & Song, X. (2011). The impact of education on unemployment incidence and re-employment success: Evidence from the US labour market. Labour Economics, 18(4), 453–463. https://doi.org/10.1016/j.labeco.2011.01.003

    Article  Google Scholar 

  • Robinson, K. E., Kuttesch, J. F., Champion, J. E., Andreotti, C. F., Hipp, D. W., Bettis, A., ... & Compas, B. E. (2010). A quantitative meta-analysis of neurocognitive sequelae in survivors of pediatric brain tumors. Pediatric Blood & Cancer, 55(3), 525-531. https://doi.org/10.1002/pbc.22568.

  • Rubin, J. B., & Schlaggar, B. L. (2019). To each, his/her own. Neuro-oncology, 21(10), 1217–1218. https://doi.org/10.1093/neuonc/noz143

    Article  Google Scholar 

  • Saury, J. M. G., & Emanuelson, I. (2011). Cognitive consequences of the treatment of medulloblastoma among children. Pediatric Neurology, 44(1), 21–30. https://doi.org/10.1016/j.pediatrneurol.2010.07.004

    Article  Google Scholar 

  • Schreiber, J. E., Gurney, J. G., Palmer, S. L., Bass, J. K., Wang, M., Chen, S., ... & Gajjar, A. (2014). Examination of risk factors for intellectual and academic outcomes following treatment for pediatric medulloblastoma. Neuro-oncology, 16(8), 1129-1136. https://doi.org/10.1093/neuonc/nou006.

  • Tiemeier, H., Lenroot, R. K., Greenstein, D. K., Tran, L., Pierson, R., & Giedd, J. N. (2010). Cerebellum development during childhood and adolescence: A longitudinal morphometric MRI study. Neuroimage, 49(1), 63–70. https://doi.org/10.1016/j.neuroimage.2009.08.016

    Article  Google Scholar 

  • Tombaugh, T. N. (1996). Test of memory malingering: TOMM. Multi-Health Systems Inc..

    Google Scholar 

  • Torgesen, J. K., Wagner, R., & Rashotte, C. (2012). Test of Word Reading Efficiency:(TOWRE-2). Pearson Clinical Assessment.

    Google Scholar 

  • Ventura, L. M., Grieco, J. A., Evans, C. L., Kuhlthau, K. A., MacDonald, S. M., Tarbell, N. J., ... & Pulsifer, M. B. (2018). Executive functioning, academic skills, and quality of life in pediatric patients with brain tumors post-proton radiation therapy. Journal of Neuro-oncology, 137(1), 119-126. https://doi.org/10.1007/s11060-017-2703-6.

  • Walter, A. W., Mulhern, R. K., Gajjar, A., Heideman, R. L., Reardon, D., Sanford, R. A., ... & Kun, L. E. (1999). Survival and neurodevelopmental outcome of young children with medulloblastoma at St Jude Children's Research Hospital. Journal of Clinical Oncology, 17(12), 3720-3728. https://doi.org/10.1200/JCO.1999.17.12.3720.

  • Wechsler, D. (2009). Wechsler Individual Achievement Test 3rd Edition (WIAT III) (p. 2009). The Psychological Corp.

    Google Scholar 

Download references

Acknowledgements

The authors would like to thank the Seattle Children’s Brain Tumor Program for continuing to allow the neuropsychology team to be a part of the team and participate in the care for these patients. The authors thank psychometrists, Joan Sato and Bryan Senn, for their meticulous work in completing assessments.

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Authors and Affiliations

  1. Department of Neurology, Division of Neuropsychology, Atrium Health Wake Forest Baptist, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA

    Lia K. Thibodaux

  2. Saint Charles Health Care System, Bend, OR, USA

    Jesse Bledsoe

  3. Seattle Children’s Hospital, Seattle, WA, USA

    David Breiger

  4. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA

    David Breiger

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  1. Lia K. Thibodaux
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Correspondence to Lia K. Thibodaux.

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Thibodaux, L.K., Bledsoe, J. & Breiger, D. Sex Differences, Academic Outcomes, and the Impact of Cranial Radiation in Pediatric Medulloblastoma. J Pediatr Neuropsychol 8, 149–154 (2022). https://doi.org/10.1007/s40817-022-00131-3

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